摘要
目的:本研究旨在评估中国经皮冠状动脉介入治疗(PCI)患者年龄、血肌酐和射血分数(ACEF)评分对远期死亡率的预测价值。方法:入选阜外医院2013年1月至2013年12月接受PCI治疗且术前有血肌酐和射血分数测定结果的患者,排除既往曾行冠状动脉旁路移植术或本次PCI为杂交手术的患者,最终纳入10072例患者。根据ACEF评分结果采用三分法将入选患者分为3组:ACEF低分组(ACEF评分≤0.838,n=3339),ACEF中间分组(0.838<ACEF评分≤1,n=3404),ACEF高分组(ACEF评分>1,n=3329)。研究终点为PCI术后2年全因死亡。结果:ACEF评分越高的患者合并的临床病症越多,冠状动脉病变越复杂。随着ACEF评分增加,患者PCI术后2年死亡率亦逐渐增高(Log-rank P<0.001)。多因素Cox回归分析显示,ACEF评分是2年全因死亡的独立危险因素(每增加1分,HR=3.971,95%CI:2.983~5.286,P<0.001)。根据ROC曲线结果,ACEF评分对2年死亡率有较好的预测能力(AUC=0.740,Hosmer-Lemeshow检验P>0.05)。与SYNTAX评分及其衍生评分相比,ACEF评分预测PCI患者2年死亡率更有优势,ACEF评分综合区分改善度(IDI)有显著性改善(P均<0.001)。结论:对于中国的PCI患者人群,ACEF评分是一个简单且有效的预测远期全因死亡的评分工具。
Objectives:The aim of the present study was to validate the predictive value of the ACEF score in coronary artery disease(CAD)patients undergoing percutaneous coronary intervention(PCI)in China.Methods:From January 2013 to December 2013,a cohort of 10724 consecutive patients underwent PCI in Fuwai Hospital were screened.Inclusion criterion included available ejection fraction and serum creatinine values before PCI procedure.Patients with previous coronary artery bypass grafting or received hybrid procedure were excluded.Finally,our study included 10072 patients.The endpoint was 2-year all-cause death following PCI procedure.Results:Patients with the higher ACEF score had more clinical comorbidity and more complicated coronary lesions.The 2-year all-cause mortality increased in proportion increasing ACEF score(Log-rank P<0.001).Multivariate regression analysis indicated that ACEF score was the independent predictor for all-cause death(HR=3.971 per 1 point,95%CI:2.983-5.286,P<0.001).The ACEF score displayed good predictive ability for 2-year mortality(AUC=0.740,Hosmer-Lemeshow test P>0.05).Compared with SYNTAX score and SYNTAX-derived scores,ACEF score showed better predictive ability.Conclusions:The ACEF score is a simple and useful risk stratification tool in CAD patients undergoing PCI in China.
作者
高国峰
周林丽
张冬
宋卫华
丰雷
朱成刚
管常东
徐波
窦克非
尹栋
GAO Guofeng;ZHOU Linli;ZHANG Dong;SONG Weihua;FENG Lei;ZHU Chenggang;GUAN Changdong;XU Bo;DOU Kefei;YIN Dong(Department of Cardiology,National Center for Cardiovascular Diseases and Fuwai Hospital,CAMS and PUMC,Beijing(100037),China;不详)
出处
《中国循环杂志》
CSCD
北大核心
2019年第11期1047-1054,共8页
Chinese Circulation Journal
基金
首都临床特色应用研究与成果推广(Z161100000516095)
作者简介
共同第一作者:周林丽;通信作者:尹栋,Email:pumcyd@163.com。
